“We were living a good life, until one day, my husband had an accident and was paralyzed. Our lives turned upside down,” says Hajra Bibi, a resident of Union Council Charun, Chitral District, Khyber Pakhtunkhwa."I learned about the importance of menstrual hygiene and also learned to make sanitary pads at home," says Hajra Bibi “My husband was the sole breadwinner for the family but after his accident, I had to take over. I started selling hand-embroidered clothes, but that was not enough. Every day was a challenge, as I had to meet all household expenses and also pay my six-year-old daughter’s school fee.”

“Last year, owing to my sewing skills, I got selected for a Menstrual Hygiene Management (MHM) training, organized by UNICEF. I learned about the importance of menstrual hygiene and also learned to make sanitary pads at home. I started making pads and selling them to girls and women in my community. With time, the demand increased and so did my income. Most of the girls and women in the community buy sanitary pads from me. Good times seem to have come back,” says Hajra, smiling as she takes a break from stitching.

Hajra lives in a small cottage at the corner of a narrow muddy street in village Kuri Junali. Located along the base of Hindukush Mountains, the village is more than 100 kilometers uphill from the city of Chitral. The distance, hilly route, and extreme weather add to the cost of living as it can take days for supplies to reach the local market.

A pack of eight sanitary pads costs around 250 rupees (over two dollars). While talking about menstrual hygiene in this area is considered a taboo, high costs of pads further exacerbate the situation. As a result, a majority of the women prefer using a piece of cloth that is often washed and reused over and over again. This could cause infections, putting girls and women’s health at risk. Many a times, these infections go untreated as menstruation and gynecological issues are considered a matter of shame, therefore, no one talks about them.

In 2016, UNICEF initiated a Multi-Year Humanitarian Program under the Pakistan Approach to On challenges of producing and selling sanitary pads, Hajra says, “Initially, women hesitated to buy from me as coming to my home would give away the reason of their visit. But now we are all confident. Besides, what’s the shame in it? It is a natural process and hygiene is more important than shame.”Total Sanitation (PATS) that sought to improve sanitation and well being of the people in Chitral. Funded by the United Kingdom’s Department for International Development (DFID) and implemented by the Agha Khan Rural Support Programme (AKRSP), one of the key objectives of the project was to educate communities on the importance of proper menstrual hygiene and promote local solutions to hygienic, affordable and environmentally sustainable menstrual supplies. The project was implemented in three Union councils of Chitral district: Charun, Mulkhow and Kosht.

Some community women were given entrepreneurial trainings to produce and sell home-made sanitary pads. They were trained to prepare hygienic sanitary pads at home, using material that is easily available in the market at a low cost. These entrepreneurs are not only producing and selling MHM kits, but are also educating and training other women in their communities.

“We would always use old pieces of cloth during menstruation days as purchasing sanitary pads from the market was not only expensive but also embarrassing as most shopkeepers are men,” says Mahrosh Alam (17). “Hajra not only sells sanitary pads but also shares useful information on menstrual hygiene which is not available to us from anywhere else.”

On challenges of producing and selling sanitary pads, Hajra says, “Initially, women hesitated to buy from me as coming to my home would give away the reason of their visit. But now we are all confident. Besides, what’s the shame in it? It is a natural process and hygiene is more important than shame.”

Following the project’s success and increasing demand, UNICEF has expanded the initiative to three additional union councils in Chitral District between 2018-2019. During this time, UNICEF aims to reach more schools benefitting at least 6,000 adolescent girls and training around 50 women including health workers and community leaders.

Speaking on the importance of breaking the taboos around MHM, UNICEF Chief of Water Sanitation and Hygiene, Kitka Goyol says, “The silence around menstruation has led to a lack of knowledge and choice about safe and reusable options for menstrual products for many women, especially in rural areas. Hajra and many other women like her, around the country, are showing us that little resources can go a long way in enabling girls and women manage their menstruation with dignity. UNICEF will continue to advocate for access to safe sanitary solutions for women, as this is their right.”